哮喘联盟

   摘要
   目的：调查问卷在评价哮喘控制中起着关键的作用。目前已有不同的调查问卷。然而，他们是否可以交换使用在很大程度上仍未知。为了知道一组常用评分是否可以给出哮喘控制的相似测量。本研究的目的在于评价五种特定问卷的一致性。
   方法:本研究为前瞻性研究，99例患者完成5种哮喘控制常用评分：GINA，哮喘控制测试™，皇家学院医生评分，哮喘治疗评估问卷(ATAQ)，哮喘控制问卷(©) (ACQ)。Kappa系数来评价问卷的一致性。
   结果:GINA与其他评分仅仅存在中度一致性(kappa系数为0.41-0.60)。至于“控制”水平，所有其他评分的结果要高于GINA。所有其他评分也往往低估了GINA“未控制水平”。5个问卷中的3个规定了“部分控制水平”，ACQ鉴别患者百分比与GINA相同，而ATAQ则高估了这个百分比。
   结论:本研究显示哮喘控制的5种常用评分仅表现出中度的一致性。GINA评分显示出最低的控制百分比和最高的哮喘未控制百分比。因此，所有的评分似乎都不能评估相同的症状。
 

（林江涛 审校）
Respir Med. 2013 Sep;107(9):1314-21. doi: 10.1016/j.rmed.2013.07.003. Epub 2013 Jul 26.


 

Asthma control measurement using five different questionnaires: A prospective study.
 

Vermeulen F, de Meulder I, Paesmans M, Muylle I, Bruyneel M, Ninane V.
 

Abstract
OBJECTIVE: Questionnaires play a key place in the assessment of asthma control. Different questionnaires have been developed. However, it remains largely unknown whether they can be used interchangeably. We wondered whether the panel of frequently used scores would give similar measurement of asthma control. The present study aimed to assess the agreement between five specific questionnaires.
METHODS:In this prospective study, ninety-nine patients completed five commonly used asthma control scores: the GINA, the Asthma Control Test™, the Royal College of Physician score, the Asthma Therapy Assessment Questionnaire (ATAQ), and the Asthma Control Questionnaire(©) (ACQ). The kappa coefficient was used to assess the agreement between questionnaires.
RESULTS:The agreement between the GINA and other scores was only moderate (kappa coefficients amounted from 0.41 to 0.60). With respect to the "controlled" level, all the other scores gave higher results than GINA. All other scores also tended to underestimate GINA "uncontrolled level". For the "partly controlled level" defined by 3 of the 5 questionnaires, ACQ identified the same percentage of patients than GINA while ATAQ overestimated this percentage.
CONCLUSION:This study shows only moderate agreement between five commonly used asthma control scores. The GINA score showed the lowest percentage of controlled and the highest percentage of uncontrolled asthma. As a consequence, all these scores do not seem to evaluate the same symptoms.
 

Respir Med. 2013 Sep;107(9):1314-21. doi: 10.1016/j.rmed.2013.07.003. Epub 2013 Jul 26.